March 10, 2021
IN THIS ISSUE / March 10, 2021
Periungual warts: Is intralesional antigen immunotherapy effective?
Do calcineurin inhibitors, phototherapy have a risk of skin cancer, lymphoma?
UHC extends application deadline for Designated Diagnostic Provider Program
Periungual warts: How effective is intralesional antigen immunotherapy?
A study published in the Journal of Cutaneous Medicine and Surgery explored the efficacy of intralesional antigen immunotherapy for the treatment of periungual warts, including the measles, mumps, rubella (MMR) vaccine, Candida antigen, and purified protein derivative (PPD).
In the study, 150 patients were randomly assigned to receive one of the three immunotherapy treatments. Each agent was injected intralesionally at a dose of 0.1 mL into the largest wart at two-week intervals until complete clearance or for a maximum of five sessions.
Complete clearance of warts was achieved in 80% of the Candida antigen group, 74% of the MMR group, and 70% of the PPD group. The number of sessions required ranged from 1.88 (Candida) to 4.22 (MMR). After six months, no recurrence was noted in all treatment groups.
Remedies for warts abound, but high-quality studies are lacking. Read more in this month’s DermWorld.
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DermWorld Insights and Inquiries: A shot in the dark
The above scenario has recently been reported through correspondence in the New England Journal of Medicine. The authors of the letter describe a series of 12 patients with delayed large local reactions with a variable appearance to the COVID mRNA-1273 vaccine. The median onset was 8 days after the vaccine. Keep reading!
How does baricitinib fare in alopecia areata?
At the most recent Maui Derm Conference for Dermatologists in January, investigators presented positive results for baricitinib in patients with alopecia areata. In an ongoing multicenter, randomized, double-blind trial, researchers enrolled adults with alopecia areata with a Severity of Alopecia Tool (SALT) score of 50 or higher.
Patients were assigned to receive either 1 mg baricitinib, 2 mg baricitinib, 4 mg baricitinib, or placebo. At week 36, 52% of patients in the 4 mg group and 33% in the 2 mg group achieved a SALT score of 20 or less, compared with 4% in the placebo group. According to the study authors, the results support the potential use of baricitinib in the treatment of patients with alopecia areata with at least 50% scalp hair loss.
Learn about the theory behind the use of platelet rich plasma for dermatologic procedures in DermWorld.
Related content:
Is there a genetic basis of central centrifugal cicatricial alopecia? – DermWorld (July 2019)
Tofacitinib for adolescent alopecia areata – DermWorld Insights and Inquiries (January 2017)
Do calcineurin inhibitors, phototherapy have a risk of skin cancer, lymphoma?
In a multicenter retrospective study published in JAAD, investigators found no association of lymphoma, non-melanoma skin cancer (NMSC), or melanoma with either increasing use of topical calcineurin inhibitors (TCI) or narrowband UVB phototherapy.
More than 25,000 vitiligo patients were grouped by cumulative TCI use (<60 g, 61-300 g, and >301 g) and by number of phototherapy sessions (0-2, 3-100, >100 sessions). The incidence rate of lymphoma in the group was 13.6 per 100,000 person-years. Compared with the <60 g group, there was no difference in the incidence of lymphoma with increased TCI use. The incidence of non-melanoma skin cancer (NMSC) was 16.8 per 100,000 person-years, and it did not significantly vary with the use of TCIs or phototherapy exposure. Only two of 16 cases of NMSC developed at sites of vitiligo treatment.
Related content:
UHC extends application deadline for Designated Diagnostic Provider Program
UnitedHealthcare (UHC) recently informed the AADA that it plans to extend the application deadline for its Designated Diagnostic Provider Program to April 30, 2021. This news follows AADA advocacy efforts to delay implementation of the program and extend the application deadline beyond the original date of Feb. 28, 2021. The AADA also requested that the program implementation be delayed and asked for more details about the criteria for participating. The Academy is waiting for a response to these requests.
What you can do:
Share your concerns or questions with UHC via email
